Tumor to cervical spinal cord standardized uptake ratio (SUR) improves the reproducibility of <sup>18</sup>F-FDG-PET based tumor segmentation in head and neck squamous cell carcinoma in a multicenter setting.
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Date
2019-01ICR Author
Author
van den Bosch, S
Dijkema, T
Philippens, MEP
Terhaard, CHJ
Hoebers, FJP
Kaanders, JHAM
Oyen, WJG
Type
Journal Article
Metadata
Show full item recordAbstract
Background In quantitative FDG-PET data analysis, normalization of the standardized uptake value (SUV) with an internal image-derived standard improves its reproducibility. In this study, the cervical spinal cord is proposed as an internal standard that is within the field of view of the radiotherapy planning PET/CT-scan in head and neck cancer. The aim is to evaluate if the tumor to cervical spinal cord standardized uptake ratio (SUR) can improve the reproducibility of a model to determine the metabolic tumor volume (MTV) on FDG-PET/CT in a multicenter setting.Materials and methods Ninety-five radiotherapy planning FDG-PET/CT-scans of patients with head and neck cancer were analyzed using the Bland-Altman method to evaluate differences in FDG-uptake in the cervical spinal cord and the mediastinal blood pool. Non-linear regression analysis was used to determine the optimal MTV using the gross tumor volume (GTV) as ground truth and a spatial overlap-index as statistical validation metric. Reproducibility was evaluated using the Bland-Altman method and external validation was performed in an independent dataset consisting of 62 patients.Results Bland-Altman's analyses demonstrated equivalence of FDG-uptake in the mediastinal blood pool and the cervical spinal cord. Reproducibility of the models improved when using SUR instead of SUV. These results were confirmed in the validation cohort.Conclusion The use of the tumor to cervical spinal cord SUR instead of SUV improves the reproducibility of a model to determine the MTV on FDG-PET/CT in a multicenter setting. This study indicates that SUR may be preferred over SUV based approaches.
Collections
Subject
Humans
Head and Neck Neoplasms
Fluorodeoxyglucose F18
Radiopharmaceuticals
Radiotherapy Planning, Computer-Assisted
Tumor Burden
Regression Analysis
Retrospective Studies
Cohort Studies
Reproducibility of Results
Adult
Aged
Middle Aged
Female
Male
Cervical Cord
Positron Emission Tomography Computed Tomography
Squamous Cell Carcinoma of Head and Neck
Research team
Translational Molecular Imaging
Language
eng
Date accepted
2018-06-27
License start date
2019-01
Citation
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019, 130 pp. 39 - 45